What is a Trigger Point?

A trigger point is a painful spot within a muscle which becomes painful when pressed upon.  When pressed on, trigger points feel like “knots” or tight bands in the muscle, and are usually tender. Healthy muscles usually do not contain knots or tight bands and are not tender to pressure.

There is not conclusive research on the definition of a trigger point.  However, many characteristics have been observed for decades by researchers all over the world. There are many mechanisms by which we develop trigger points. Some of those mechanisms include poor posture, injury to a muscle, muscle overuse, and repetitive stress overload. Trigger points limit range-of-motion and cause muscle fatigue.

Physical Therapy is a common treatment option for trigger point pain. Physical Therapy addresses trigger points by identifying and treating the primary driver of the trigger point.  This is done through trigger point release techniques, massage, dry needling, therapeutic exercise, and posture re-education.  If you are interested in learning how physical therapy can help with your trigger point pain, make an appointment at Harbor Physical Therapy.

The Big 3 Ws (What, Why & When) about a Home Exercise Program (HEP)

What is a HEP?

A HEP is a set of customized exercises that patients complete at home to maintain and improve on therapeutic gains from their Physical Therapy sessions. HEPs are designed to be practical, simple and complimentary so that patients can perform at home with little to no guidance.

Why do I need a HEP?

For almost all physical therapy patients, an essential component of recovery is supplementing your physical therapy sessions with your recommended HEP. Poor compliance with performing the HEP will slow the rehab process and prevent the patient from reaching their physical therapy goals.  Here’s an analogy to help drive home the point.

Imagine if you had an infection, and your doctor gives you an antibiotic to take twice a day for 2 weeks. If you skip taking your antibiotics medication for 2-3 days, you don’t give your body the best chance to fight off the infection. The infection persists, and the treatment might take longer and be more expensive. So, performing your HEP is a way of daily taking your exercise medication to supplement the gains made with your physical therapist.

When should I get a HEP?

We as therapist have done you the patient a big disservice if we don’t give you the tools to maintain and progress the gains you make during your sessions with us. A HEP should be provided from day 1 of your therapy and periodically updated as you progress over the weeks and months. Upon discharge from physical therapy, an updated and final HEP should be provided. In the event of symptom exacerbation post physical therapy, your HEP should provide you with tools to manage your symptoms and maintain a state of wellness.

 

Written by:
Dr. Nelson Emokpae
Physical Therapist at HPT

How to Relieve Lower Back Pain

Many people will experience lower back pain during the upcoming winter season. It may be from shoveling, decorating, or your usual daily activities. A common reason people experience lower back pain is due to muscle tightness. To help decrease muscle tightness, try these stretches below.

  1. Lower Trunk Rotation– This stretch helps to decrease muscle tightness located at your lower back and upper butt region. Perform 10 repetitions and hold for 5 seconds each.

  2. Single Knee to Chest stretch– This stretch helps to decrease pressure on your spine by creating flexion. Perform 4 on each side and hold for 30 seconds each.

  3. Seated Hamstring Stretch– This stretch helps to increase hamstring flexibility. This will decrease the hamstring muscle from pulling on the back musculature causing pain.

If you continue to have pain, please contact Harbor Physical Therapy for a thorough evaluation to determine the source of your back pain and an appropriate plan of care.

What is Dry Needling?

Dry needling is a treatment involving a thin needle, used to target a painful trigger point. A physical therapist feels for the trigger point and then inserts the needle. The needle helps to release the tightness, stimulate blood flow, and promote relaxation to the aggravated muscle. Dry needling is one possible treatment option to be used in conjunction with massage, exercise, heat/ice to help manage pain.  Results can vary from person to person and can range from very short term (hours-days) to more permanent effects.  A physical therapist in the state of Maryland receives special education after physical therapy school to receive a certification in dry needling.  At Harbor Physical Therapy, Dr. David Reymann is a certified myofascial trigger point therapist.  If you are interested in trying dry needling or learning more about it, give Harbor Physical Therapy a call at 443-524-0442.   

How to Prevent Back Pain with Household Chores

If a household chore is not done with proper biomechanics, you are more likely to strain you back muscles resulting in pain.  Lots of household chores are repetitive so it is a good rule of thumb to use both the right and left side of your body equally to avoid an overuse injury.  Check out the tips below highlighting some specific household chores and body positioning that will decrease strain on your back muscles.

  1. Washing dishes– to decrease back strain at the sink, open the base cabinet and put your foot up on the ledge to become closer to the sink.
  2. Vacuuming– Walk with the vacuum or lunge forward onto one foot keeping your back straight, rather than bending forward with each push of the vacuum.
  3. Making the bed– Put one knee down on the bed when fastening a sheet to the corner of the mattress or squat to fasten it.
  4. Grooming– Put one hand down on the counter in the bathroom while using the other to brush your teeth or shave. Also, you can put a foot up onto the ledge of the base cabinet as in the kitchen.

Stretching 101

To get the most out of stretching to prevent injury and muscle soreness, dynamic stretching should be performed before your workout and static stretching performed after your workout.  If you perform a static stretch before you workout, there is more potential to tear a muscle due to the lack of blood flow at the muscle.

To get the most benefit out of static stretching, make sure you hold the stretch at a point you feel a pull within the muscle. The stretch should be held between 15-60 seconds.  Perform 2-3 repetitions of each stretch on both sides of your body. If a stretch is painful, you should decrease the range of motion of the stretch.

If you are unsure what muscle groups to stretch in association with your workout, contact Harbor Physical Therapy.  Our physical therapists can create you a customized stretching program.

The Rotator Cuff: What You Need to Know

The rotator cuff, an often neglected muscle group, is a group of four muscles and tendons that surround the shoulder joint.  The rotator cuff helps to keep the head of your upper arm bone firmly within the shallow socket of the shoulder joint. In addition to keeping your shoulder stable, these muscles help to lift and rotate your arm. Injury to this muscle group is common, particularly in those who perform repetitive overhead motions as you would in a sport like tennis or a profession like painting.

The key to preventing shoulder pain or injury to these muscles is maintaining good rotator cuff strength in addition to good posture to improve your shoulder mechanics. Here are four simple exercises that you can start performing at home to start building better shoulder strength and stability.

  1. Side-lying External Rotation with Weight

     2.  Shoulder Internal Rotation with Band

     3.  Scapular Rows

If you are currently suffering from shoulder pain, the physical therapists at Harbor Physical Therapy will help you to develop an exercise program that is specific to your injury.

 

Written by:

Dr. David Reymann

Staff Physical Therapist
Harbor Physical Therapy

Six Reasons to Start Walking This Summer

While walking may seem like an obvious form of exercise, most people do not walk enough for exercise. The American Heart Association recommends getting at least 150 minutes of moderate intensity aerobic activity per week. The good news is that brisk walking falls under this category. Walking is a great form of exercise because it is easy to fit in your schedule, it can be done anywhere, and you don’t need any fancy or expensive equipment to do it. Here are just a few of the many health benefits of walking:

  1. Walking makes you stronger. Walking is a good way to get your muscles activated and helps to improve muscular strength and endurance.
  2. It is good for your heart. Walking helps to improve cardiovascular and pulmonary health and can improve your endurance for all of your daily activities.
  3. It can help you to maintain a healthy weight.
  4. It decreases your risk for many health conditions and diseases including diabetes, cardiovascular disease, and cancer.
  5. Walking can help to improve your mood and decrease stress.
  6. Walking is a weight-bearing exercise that helps to build strong bones. Maintaining good bone health will decrease your risk of osteoporosis.

Written By:
Dr. David Reymann
Staff Physical Therapist at Harbor Physical Therapy

Common Causes of Sciatica

What is sciatica?

Sciatica is a term commonly used to describe pain, weakness, numbness, or tingling that radiates down the back of the leg. These symptoms can be debilitating for some and contribute to difficulty performing daily activities.

Where does it come from?

There are 4 common causes of sciatica:

  1. Disc Herniation – Pressure on the sciatic nerve can occur from the protrusion of a disc in the lumbar spine. This pressure can cause pain to travel through the pathway of the sciatic nerve down the leg.
  2. Spinal Stenosis – Narrowing of the space where the nerve roots exit the spinal canal can also cause pressure on the nerve.
  3. Piriformis Syndrome – The piriformis is a muscle deep in your gluteal region that the sciatic nerve runs underneath and sometimes through. Tightness or spasm of this muscle can cause pressure on the nerve that sends pain down the leg.
  4. Referred Pain from Trigger Points – Trigger points are tight knots in muscles that can cause local or referred pain. Trigger points found in the gluteal muscles can cause referred pain that is felt down the leg and is similar to sciatic nerve pain.

How can PT help?

 A physical therapist is trained to evaluate your symptoms and do a thorough assessment to determine what may be causing them. The aim of treatment is to restore your range of motion, increase your flexibility, increase strength and stability, decrease trigger point formation, and improve your functional mobility. Treatment plans are individualized and are determined based on the causes of your symptoms and your specific presentation. If you are suffering from sciatica-related symptoms, call Harbor Physical Therapy to help eliminate your pain and prevent it from reoccurring.

Written by:

Dr, David Reymann
Staff Physical Therapist at Harbor Physical Therapy

Increase Computer Time and Pain Prevention

Do you sit in front of the computer most of the day? Do you get tension headaches, neck pain, and sore chest muscles?

This is a result of repetitive forward head movement that can be from typing, reading and looking down to write. Excessive forward head posture puts strain on your neck and shoulder muscles. Perform the pectoralis stretch below to decrease strain to your neck and shoulder muscles.

Stand in a doorway and place your arms about 90 degrees along the sides of the door frame. Step through the door frame until you feel a stretch across your chest. Hold the stretch for 20 seconds. Alternate your foot forward with each stretch.

Pectoralis Stretch

Written by:
Amanda Macht, D.P.T.
Owner/Physical Therapist at Harbor Physical Therapy